“What’s the story?” I ask as I walk into room 12-240. I’ve done this dance so many times today in so many different rooms all over the tower. The patient I face now is unknown to me. Strands of information are being volleyed back and forth, painting in the fuzzy lines that are rapidly shaping into a portrait of a sick man getting sicker by the minute. Heart rate, blood pressure, oxygen sat, meds, medical history, risk of infection, cancer treatments, access, pushing meds, pads on, shockable rhythms. I crack a few jokes with him, trying to keep it light and keep the room calm. It works for a little while, but soon he is tanking. The fatigue of fighting to breathe is taking its toll, and we are beyond the limits of the non-rebreather to rebreathe life into this man.
MICU arrives. Anesthesia, stat. Transfer orders are in. After the crowd has dispersed, the empty room is littered with the detritus of the frenetic activity of placing IVs, drawing blood, and hanging meds. I don’t know this yet, but tomorrow by noon, he will be dead, our interventions unable to beat back the rapid pace of the bacteria that are ravaging his weakened body.
When I’m back tomorrow, caffeinated if not rested, every trace of yesterday’s emergency will have been completely cleared by a housekeeper working diligently to restore the room to rights. Evidence that he was ever here will be erased, and the dramatics of the night before will be only a memory stored in the EHR. I’ll walk into 12-240 again, this time with a sick patient getting sicker, and have a difficult conversation about the end of her life. The patient’s daughter will quietly agree with her mother’s wishes to die with dignity. The patient’s son, who lives across the country, will arrive just in time to disagree violently. The conversation will go on, the right words ringing hollow in my dry mouth, too weak to extinguish the rage and grief and love of a man unprepared to lose his mother.
When I’m back tomorrow, I will realize that 12-240 isn’t just a 12-by-12-foot room painted with bland sea foam green walls but is, in fact, a portal, much like Narnia. Opening the door each day unfolds a new landscape of heightened human emotions for me to navigate—grief, distress, panic, angst, rage, hope, and love.
When I’m back tomorrow, I will have a moment of crisis where I wonder why I signed myself up for a job where I always have to be the adult in the room, the responsible party, the one with the answers. I will take refuge in the office with my colleagues for a moment. They will understand immediately when I describe this conversation I’ve just had. They will murmur assent, and someone will throw out a story of their own, and we will have a moment of shared understanding. My faith will be restored, and my gratitude for my profession will be renewed. A few hours later, I’ll be called back to 12-240 with the request to start hospice proceedings. The relief on the patient’s face will be palpable, and she will be discharged home to finish her journey surrounded by family. I might shed a few tears in the office, partially relief and partially grief.
When I’m back tomorrow, I’ll realize the privilege of being at the bedside, historian of the stories of yesterday and the unfolding of both life and death in a way that few outside our profession ever will. When I’m back tomorrow, room 12-240 will be occupied once more, and we will begin again once more, the same sea-foam green walls silently bearing witness to the new stories unfolding.
I will be back tomorrow.
“Room 12-240” is a 2025 National Hospitalist Day HM Voices Contest Winner
Dr. Nadamuni is an oncology hospitalist and assistant clinical professor of medicine at Yale Smilow Cancer Center in New Haven, Conn.